Provider Demographics
NPI:1376683169
Name:WESTVIEW PHARMACY
Entity Type:Organization
Organization Name:WESTVIEW PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:R
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:918-425-1385
Mailing Address - Street 1:PO BOX 6028
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74148-0028
Mailing Address - Country:US
Mailing Address - Phone:918-425-1385
Mailing Address - Fax:918-430-0118
Practice Address - Street 1:3606 N CINCINNATI AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1536
Practice Address - Country:US
Practice Address - Phone:918-425-1385
Practice Address - Fax:918-430-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22775332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100238600BMedicaid
OKOKA101554OtherPTAN
OKOKA101554OtherPTAN